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Jan 11, 2011

Healthy lifestyle decreases risk of AMDModifying lifestyle behaviors of diet, smoking, and physical activity may reduce the risk of age-related macular degeneration (AMD) as much as 3-fold, according to a new study.

The population included 1313 participants (aged 55-74 years) in the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women's Health Initiative Observational Study. Scores on a modified 2005 Healthy Eating Index were assigned using responses to a food frequency questionnaire administered at baseline of the Women's Health Initiative Observational Study (1994-1998). Physical activity and lifetime smoking history were queried. An average of 6 years later, stereoscopic fundus photographs were taken to assess the presence and severity of AMD; it was present in 202 women, 94% of whom had early AMD, the primary outcome.

In multivariate models, women whose diets scored in the highest quintile compared with the lowest quintile on the modified 2005 Healthy Eating Index had 46% lower odds for early AMD. Women in the highest quintile compared with those in the lowest quintile for physical activity (in metabolic energy task hours per week) had 54% lower odds for early AMD. Although smoking was not independently associated with AMD on its own, having a combination of 3 healthy behaviors (healthy diet, physical activity, and not smoking) was associated with 71% lower odds for AMD compared with having high-risk scores (P < .001).

Modifying lifestyles might reduce risk for early AMD as much as 3-fold, lowering the risk for advanced AMD in a person's lifetime and the social and economic costs of AMD to society.

WHAT IT MEANS TO YOU: Smoking is the behavior that most strongly and consistently associated with AMD. The fact that this study did not find smoking to be independently associated with AMD makes me approach their other results with caution. Is it possible that smoking does not increase the risk of AMD in women, but only in men? I am not aware of any study that would support that hypothesis. Despite the curious smoking results, the other major findings, that a healthy diet and regular exercise can reduce the risk of AMD, are significant. The large positive benefit of both diet and exercise send a strong message that a healthy lifestyle can play a large role in preventing the development of AMD.